Provider Demographics
NPI:1356117162
Name:PIERCE, CHRISTINE DUSTYN (APP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DUSTYN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:APP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S LINDA ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-4544
Mailing Address - Country:US
Mailing Address - Phone:219-240-6218
Mailing Address - Fax:
Practice Address - Street 1:5164 E 81ST AVE STE 201
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5852
Practice Address - Country:US
Practice Address - Phone:219-240-6218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No173C00000XOther Service ProvidersReflexologist
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist